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New legal TCM regulation in Czech Republic

By Jiri Bilek

June 8th 2017 will be remembered as a pivotal point for TCM in Czech republic. That day the Senate (the upper house) of the Czech Parliament voted „yes“ for an amendment of a law regulating non-medical health care professionals, which for the first time defines educational requirements for TCM practitioners. The upper house vote was a key moment of whole process as the law went through the lower house without many obstacles.

Unlike in other countries like Switzerland or Portugal where the TCM regulation is a part of a larger norm regarding also other CAM methods, in our case the TCM was added to a law regulating non-medical professions like nurses, paramedics, physiotherapists, behavioural therapists, pharmaceutical assistants etc. The „yes“ vote came a bit as a surprise as there was a long ongoing opposing campaign by medical organisations and even the healthcare committee of the upper house did not recommend an approval.
The fact, that we have now two short paragraphs only (a loose translation together with an official rationalisation of the proposal is below the article) and not a complex law that would clearly define whole area occupied by TCM, creates among many – schools and practitioners – worries and even a fear. In the past TCM has been practiced in a grey area and despite acupuncture was given by law to hands of MDs only, nobody was ever persecuted. On the other hand it held back whole profession, didn’t allow any dynamic development and any resources from public funding was unimaginable.

Yes, we are standing at the starting line of a very uncertain area, but it is still a step forward. The new law for the first time states that „TCM officially exists“ in the Czech legal system, so we can claim its part in the health care service. The practitioners are defined by a level of an academic education which is fundamentally right, but it is at the same time a source of those worries and confusion. From now on practitioners are required to fulfil certain standards, but at the moment nobody knows where they should obtain them and who will evaluate it. The current schools are not recognised despite their demonstrable quality and the opposition by the medical society makes a cooperation on an academic level intricate. The new law doesn’t also define any transient period nor grandfathering of already practicing TCM practitioners and current students.

The role of our professional association CCTCM (The Czech Chamber of TCM) in the whole process is not really clear as well. We are always asked and demanded when there is any expert opinion needed (by government, parliament or media), but then keep being ignored and not invited for participating in creating the further standards. This is our major challenge and focus for our further work and lobbying activities. It is obvious, that nobody else but us knows or understands what TCM is and needs in order to create and keep quality standards. The only other option is ignoring the current TCM reality in our country and import experts from China, which is already starting to happen.
This might lead to a question: „What is the background of the political push that allowed to pass this law?“ We can see without any doubts that it is a byproduct of intensifying bilateral relations with China motivated by business on the one side and political influence on the other. We see some politicians that talk about TCM as „us“ and fight for its benefits and it is obvious that they have only limited understanding of whole problematic. From the same politicians we have received unofficial assurance that our TCM community will not be jeopardised. Another comforting fact is that the general public expresses a positive reaction on the new TCM regulation and demands further steps.

Yes, the whole situation is a bit confusing at the moment, but promising at the same time. The uncertainty might create worries, but we shall see it as an achievement that we have participate on. The parliament has said „A“ and we have to do everything we can to keep participating on „B“ (i.e. following steps). It might take years to get a fully-fledged and officially recognised TCM academic course, but the journey has started. Here we might need a support of our European TCM community. Not only that we can use the experiences of the more developed colleague countries, but with the help of ETCMA we shall rise a loud voice that TCM has not a Chinese reality only and and there has been a unique quality of TCM created over last decades in the culturally Western world where we are belong. The need for the European core curriculum and kate mark seems from the current Czech perspective more urgent than ever.
It is evident that what is happening in Czech Republic, might (and probably will) happen also in other European countries and thats why we shall stick in this together. It might have a different scenarios, but each such case will make our European TCM community more experienced and brings us closer to our common goal.

What is stated in that new law?

Professional qualification for TCM Therapist can be acquired by:
- graduating from at least 3years long accredited bachelor degree course of TCM
- acquiring of qualification of a nurse, physiotherapist, ergo-therapist, nutritional therapist or pharmaceutical assistant together with accredited course of TCM
TCM Therapist is allowed to be engaged in a prophylactic, diagnostic or curative care in TCM under a supervision of a qualified medical doctor or TCM Specialist

Professional qualification for TCM Specialist can be acquired by
- graduating from at least 5years long accredited masters degree course of TCM
- acquiring of qualification of medical doctor together with accredited course of TCM
TCM Specialist is allowed to be engaged independently in a prophylactic, diagnostic or curative care in TCM

Suggested regulation are submitted in order to clearly and transparently define educational requirements for TCM. There are many undefined subjects in the Czech Republic that claim to provide TCM without any possibility to verify their qualification, extent and quality of their care.
We have to take into consideration the growing popularity of TCM among public, which culminated after 2015 Nobel Prize in Medicine awarded for a discovery based on ancient Chinese medical texts.
This unambiguous regulation allows educate in TCM both, the current health care professionals who will be able to extend their knowledge and scale of their care, as well as new aspirants interested in TCM. It offers a legislative bounds for establishing and formal recognition of TCM in Czech Republic, which allows to utilise its knowledge and experience in health care service.
The specific content and eligibility of those professions will be defined by the implementing ordinance of the Ministry of Health. Implementing legal instructions will also define minimal requirements for educational programs that will be compulsory for obtaining a licence.
The over all aim is to create a quality framework for adequate care with use of TCM methods, e.g. acupuncture and herbal therapy.

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